Women’s relationship to food, Part I: the emotional issues

HEALTH MATTERS

By: Dr. Heidi Dalzell
   The following is the first of a three-part series examining women’s relationship to food, female body image and eating disorders.
   The week of Feb. 23-March 2 is National Eating Disorders Awareness Week.
   Eating disorders are complex problems that affect people of all ages, races and economic backgrounds. The National Eating Disorders Association notes that in the United States, 5 to 10 million girls and women and 1 million boys and men struggle with eating disorders.

"One of the healthiest things women can do is to become more aware of, and connected to, their bodies and eating patterns."


Heidi J. Dalzell, Psy.D.

Therapist, Princeton House

The Medical Center at Princeton

   When people think of eating problems, they often visualize a Twiggy-like, stick-thin model. In fact, food and body image issues are common among many women and are often a barometer of a woman’s emotional state and overall wellness.
   One of the healthiest things women can do is to become more aware of, and connected to, their bodies and eating patterns. Women are often connected to their bodies in terms of the ways others respond to them, but are disconnected from their own needs for physical and emotional satiety.
   Sociocultural expectations dictate that women balance varied and sometimes conflicting roles, such as wife, mother and employee, all the while looking attractive and composed. An area of special concern is balancing family and career, often more difficult than it appears. When the ability to keep up the appearance of capability and composure becomes too great, women may turn to food or focus on appearance.
   Women learn at an early age that food is alternately a source of comfort and something they can deny themselves as a measure of "competence." Food, then, becomes a way to cope with many different types of life stressors. In addition to balancing role demands, major life transitions — such as marriage, childbirth, a husband’s illness or a new job — may be times of particular stress, even when a women appears to be handling it well.
   These situations are the ones when we discount the extra candy she is eating, the fact that her stomach is in knots, or the strict diet she has begun. When women are able to tune in to these factors, they can take steps to balance life demands and to handle pressures in a healthier way, such as through meditation or yoga. These prac- tices enable women to become emotionally centered and to increase body awareness.
   Another time that women may struggle with food or body image issues is when they feel unheard or unable to express their emotions. Food is not the central problem, but it is one way of managing strong emotions.
   Emotions such as anger and sadness are often seen as unacceptable. Even assertive behavior, such as saying "no," may be difficult when women fear that others won’t like them or will see them as aggressive, or that their needs are being viewed as secondary. Such problems are often related to a sense of low self-esteem or insecurity. Additionally, the feelings of powerlessness and disconnectedness associated with depression may be expressed through restricting increasing food intake.
   Women may "stuff" their needs and emotions, symbolically or literally. Learning positive assertiveness and communication skills is important.
   Many of these issues were factors for Jane, an attractive woman who developed postpartum depression. She was sad all the time, had crying spells, lost her appetite and was unable to care for the baby. As a result of her depression, she was not eating and, before long, lost weight. Jane began to equate this weight loss with a feeling of being in control at a time when there were many unavoidable demands placed on her.
   Her family quickly recognized that Jane needed support and helped her to get treatment at a behavioral health facility. Treatment allowed her to verbalize the issues underlying her depression, such as feeling overwhelmed and incompetent. Jane was also able to assess the amount of energy she wanted to put into each of these demands, and to factor in time for herself. She also found it beneficial to discuss her own experiences of being mothered.
   Jane is now recovered and is able to care for herself and her baby. She continues to use the positive coping skills she gained in therapy, such as journaling and yoga.
   If you note any of the following, increased vigilance to self-care would be helpful:
   • Feelings of being overwhelmed, or unable to cope with stressors or life transitions;
   • Use of food or compulsive exercise as a way to manage these stresses;
   • Withdrawal from family or friends.
   If problems persist, you may wish to consider evaluation at a facility skilled in treating women’s issues, such as the Women’s Wellness Program at Princeton House. It is not often easy to predict when such problems will become disabling. If you or someone you know is at risk, please get help.
Heidi J. Dalzell, Psy.D., is a therapist at Princeton House, the behavioral health facility at The Medical Center at Princeton. For more information about the Women’s Wellness Program, call (609) 688-3753. This article was prepared in collaboration with Lorraine Seabrook.
Next week: Women’s relationship to food, Part II: The role of female body image.